What is Endocet 5/325. How does it compare to Percocet. What are the main uses, side effects, and precautions for Endocet. How should patients use this medication responsibly for pain relief.

Understanding Endocet 5/325: A Powerful Pain Medication

Endocet 5/325 is a prescription medication that combines two active ingredients: acetaminophen (325 mg) and oxycodone (5 mg). This potent analgesic is primarily used to manage moderate to severe pain when other treatments have proven ineffective. As a combination of an opioid (oxycodone) and a non-opioid pain reliever (acetaminophen), Endocet offers a multi-faceted approach to pain management.

How Does Endocet Work?

Endocet’s effectiveness stems from the synergistic action of its two components:

• Acetaminophen: A nonsteroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by inhibiting prostaglandin production.
• Oxycodone: An opioid that binds to mu receptors in the brain, altering pain perception and providing potent analgesia.

This combination allows for enhanced pain relief while potentially reducing the required opioid dose, which may help mitigate some risks associated with opioid use.

Endocet vs. Percocet: Comparing Two Similar Pain Medications

Endocet and Percocet are often confused due to their similarities. Both medications contain the same active ingredients (acetaminophen and oxycodone) and are used for similar purposes. The primary differences lie in branding and potentially in cost, depending on insurance coverage and availability.

Key Similarities Between Endocet and Percocet

• Active ingredients: Both contain acetaminophen and oxycodone
• Available strengths: 325 mg-2.5 mg, 325 mg-5 mg, 325 mg-7.5 mg, and 325 mg-10 mg
• Dosing schedule: Typically taken every 6 hours as needed for pain
• Common side effects: Constipation, nausea, and drowsiness
• Drug classification: Both are classified as opioids

Given these similarities, the choice between Endocet and Percocet often comes down to factors such as insurance coverage, cost, and physician preference.

Dosage and Administration of Endocet 5/325

Proper dosing of Endocet is crucial for effective pain management and minimizing the risk of side effects or complications. The typical dosage for Endocet 5/325 is one tablet every 6 hours as needed for pain. However, it’s essential to follow your healthcare provider’s specific instructions, as dosing may vary based on individual factors such as pain severity, medical history, and response to treatment.

Important Dosing Considerations

• Maximum daily acetaminophen intake: Do not exceed 4000 mg of acetaminophen per day from all sources to avoid liver damage.
• Gradual dose adjustment: Your doctor may start with a lower dose and gradually increase it to find the optimal balance between pain relief and side effects.
• Duration of use: Endocet is typically prescribed for short-term use. Long-term use should be carefully monitored by a healthcare professional due to the risk of dependence and other complications.

Always consult your healthcare provider before making any changes to your Endocet dosage or frequency of use.

Common Side Effects and Precautions of Endocet 5/325

While Endocet can be highly effective for pain management, it’s important to be aware of potential side effects and take necessary precautions. Understanding these aspects can help patients use the medication safely and effectively.

Most Common Side Effects

• Constipation
• Nausea and vomiting
• Drowsiness and dizziness
• Headache
• Itching (pruritus)
• Fatigue and lethargy

These side effects are typically mild to moderate and may decrease over time as your body adjusts to the medication. However, if they persist or worsen, it’s important to consult your healthcare provider.

Serious Precautions and Warnings

Endocet, like all opioid medications, comes with significant risks that require careful consideration:

1. Risk of dependence and addiction: Endocet has a high potential for abuse and can lead to physical and psychological dependence, even when used as prescribed.
2. Respiratory depression: Opioids can slow breathing, which can be dangerous, especially in higher doses or when combined with other central nervous system depressants.
3. Liver damage: The acetaminophen component can cause liver damage if taken in excessive amounts or by individuals with pre-existing liver conditions.
4. Interactions with other medications: Endocet can interact with numerous medications, including antidepressants, antihistamines, and other pain relievers.
5. Pregnancy and breastfeeding: Endocet is classified as Pregnancy Category C, meaning potential risks to the fetus exist. It’s also not recommended during breastfeeding.

Due to these risks, Endocet should only be used under close medical supervision and as part of a comprehensive pain management plan.

Drug Interactions and Contraindications for Endocet 5/325

Endocet can interact with a wide range of medications and substances, potentially leading to serious complications. It’s crucial for patients to disclose all medications, supplements, and substances they use to their healthcare provider before starting Endocet.

Key Drug Interactions

• Alcohol: Can increase the risk of liver damage and enhance central nervous system depression
• Benzodiazepines and other CNS depressants: May cause severe drowsiness, respiratory depression, coma, and death
• Serotonergic drugs (e.g., SSRIs, SNRIs): Can increase the risk of serotonin syndrome
• CYP3A4 inhibitors or inducers: May affect oxycodone metabolism, altering its effectiveness and side effect profile
• Monoamine oxidase inhibitors (MAOIs): Can cause severe and unpredictable reactions

This list is not exhaustive, and patients should always consult their healthcare provider or pharmacist about potential interactions.

Contraindications

Endocet is contraindicated in several situations, including:

• Known hypersensitivity to oxycodone, acetaminophen, or any component of the formulation
• Significant respiratory depression
• Acute or severe bronchial asthma in an unmonitored setting or without resuscitative equipment
• Known or suspected gastrointestinal obstruction, including paralytic ileus
• Severe hepatic impairment

Patients with these conditions or circumstances should not use Endocet and should discuss alternative pain management strategies with their healthcare provider.

Responsible Use and Addiction Prevention with Endocet 5/325

Given the high potential for abuse and addiction associated with opioid medications like Endocet, responsible use and addiction prevention are paramount. Patients and healthcare providers must work together to ensure safe and effective pain management while minimizing risks.

Guidelines for Responsible Use

1. Follow prescribed dosage: Never take more Endocet than prescribed or increase the frequency of doses without consulting your healthcare provider.
2. Time-limited use: Endocet is typically intended for short-term pain management. Work with your healthcare provider to develop a plan for tapering off the medication when appropriate.
3. Safe storage: Keep Endocet in a secure location out of reach of children and others who should not have access to it.
4. Proper disposal: Dispose of unused medication properly through drug take-back programs or as directed by your pharmacist.
5. Regular check-ins: Maintain open communication with your healthcare provider about your pain levels, side effects, and any concerns about dependence.

Recognizing Signs of Dependence or Addiction

It’s crucial to be aware of potential signs of opioid dependence or addiction, which may include:

• Taking higher doses or using the medication more frequently than prescribed
• Experiencing strong cravings for the medication
• Continuing to use Endocet even when it’s no longer needed for pain relief
• Neglecting responsibilities or relationships due to medication use
• Experiencing withdrawal symptoms when not taking the medication

If you or a loved one experience these signs, it’s important to seek help from a healthcare professional immediately. Early intervention can prevent the progression of dependence and facilitate appropriate treatment.

Alternatives to Endocet for Pain Management

While Endocet can be effective for managing moderate to severe pain, it’s not always the most appropriate option due to its potential risks and side effects. Exploring alternatives with your healthcare provider can help identify the most suitable pain management strategy for your specific situation.

Non-Opioid Medication Alternatives

• NSAIDs (e.g., ibuprofen, naproxen): Effective for many types of pain and inflammation
• Acetaminophen: Can be used alone for mild to moderate pain
• Topical analgesics: Creams, gels, or patches containing ingredients like lidocaine or capsaicin
• Antidepressants: Some types can help manage chronic pain conditions
• Anticonvulsants: May be beneficial for neuropathic pain

Non-Pharmacological Pain Management Techniques

In addition to or instead of medication, various non-pharmacological approaches can be effective for pain management:

• Physical therapy and exercise
• Acupuncture
• Cognitive-behavioral therapy
• Mindfulness and meditation
• Heat or cold therapy
• Massage therapy
• Transcutaneous electrical nerve stimulation (TENS)

The most effective pain management strategy often involves a combination of approaches tailored to the individual’s specific needs, pain condition, and overall health status. Always work closely with your healthcare provider to develop a comprehensive pain management plan that balances effectiveness with safety.

Endocet vs Percocet: Main Differences and Similarities

Endocet and Percocet are two brand names for the combination of acetaminophen and oxycodone. This combination medication is often prescribed for moderate to severe pain that is not relieved with other therapies.

Acetaminophen is a nonsteroidal anti-inflammatory drug (NSAID) that treats pain and inflammation by decreasing the production of prostaglandins. Oxycodone is an opioid that binds to mu receptors in the brain. This combination produces a strong analgesic effects to relieve pain from injury, surgery, and other conditions.

Endocet

Endocet comes in strengths of 325 mg-2.5 mg, 325 mg-5 mg, 325 mg-7.5 mg, and 325 mg-10 mg of acetaminophen and oxycodone. The usual dose of Endocet is given every 6 hours as needed for pain. Common side effects of Endocet include constipation, nausea, and somnolence.

Percocet

Percocet is available in strengths of 325 mg-2.5 mg, 325 mg-5 mg, 325 mg-7.5 mg, and 325 mg-10 mg of acetaminophen and oxycodone. Percocet can be taken every 6 hours as needed for pain depending on a doctor’s prescription. Common side effects of Percocet include constipation, nausea, and somnolence.

Endocet vs Percocet Side by Side Comparison

Endocet and Percocet are identical medications used for pain. Their features can be found in the table below.

Summary

Endocet and Percocet contain the same active ingredients, acetaminophen and oxycodone. As a potent opioid combination, Endocet and Percocet can help relieve moderate to severe pain.

Both Endocet and Percocet come in similar dosage forms. They can both be taken multiple times throughout the day as needed for pain. However, the maximum recommended daily dose of acetaminophen is 4000 mg. This is because acetaminophen can cause liver damage at high doses.

Acetaminophen and oxycodone can cause side effects such as constipation and nausea. As a Schedule II drug, this combination also has a high risk for abuse and dependence. Those who abuse acetaminophen and oxycodone report feelings of euphoria which can lead to addiction.

It is important to discuss these medications with a doctor. This information should be reviewed with a doctor to determine the best treatment option for you.

Endocet – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

This combination product contains two medications: oxycodone and acetaminophen. Acetaminophen belongs to the group of medications called analgesics (pain relievers) and antipyretics (fever reducers). Oxycodone belongs to the group of medications called narcotic analgesics. Oxycodone – acetaminophen is used to relieve moderate to moderately severe pain, including conditions associated with fever. This medication should only be used when other non-narcotic pain medications are not effective or tolerated.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Endocet is no longer being manufactured for sale in Canada. For brands that may still be available, search under oxycodone – acetaminophen. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The dosage varies according to each individual and can be affected by the severity of the pain as well as each person’s response to the medication.

The usual recommended adult dose of oxycodone – acetaminophen (each tablet contains 5 mg oxycodone and 325 mg acetaminophen) is one tablet every 6 hours as needed for pain. This medication should be used at the lowest dose that provides pain relief for a maximum of 7 days.

Swallow the tablets whole with fluid. Do not cut, break, crush, chew, or dissolve the tablets. Doing so can result in dangerous adverse events, including death.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

This medication may be habit-forming if taken for long periods of time. Do not stop taking this medication without talking with your doctor. If this medication is stopped suddenly, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shakiness, nausea, tremors, diarrhea, or hallucinations. If you plan on stopping the medication, your doctor may want you to reduce the dose gradually to reduce the severity of withdrawal effects.

It is important to take this medication exactly as prescribed by your doctor. If your doctor has told you to take this medication on a regular basis and you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

• are allergic to oxycodone, acetaminophen, or to any of the ingredients of the medication
• have severely decreased liver function or active liver disease
• have a seizure disorder
• have pre-existing respiratory depression
• have status asthmaticus (unresponsive asthma)
• are pregnant, breast-feeding, or in labour
• are taking or have taken (within the last 14 days) MAO inhibitors (e. g., phenelzine, tranylcypromine)
• have a head injury
• have a brain tumour
• have acute alcoholism
• have mild pain that can be controlled by occasional use of pain medications
• have acute asthma or other obstructive airway diseases (e.g., chronic bronchitis, emphysema)
• have cor pulmonale (heart failure caused by chronic high blood pressure in the arteries of the lungs)
• have delirium tremens (e.g., confusion, diarrhea, shaking, fever, hallucinations, disorientation) associated with alcohol withdrawal
• have increased cerebral spinal fluid pressure
• have increased levels of carbon dioxide in the blood
• have an abdominal condition that may require immediate surgery (e.g., appendicitis, pancreatitis)
• have or may have bowel or digestive system problems (e.g., paralytic ileus), or may have a blockage in the digestive system

What side effects are possible with this medication?

Many medications can cause side effects.  A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• decreased ability or interest in sexual activity
• decreased coordination
• dizziness
• drowsiness
• headache
• itching
• lightheadedness or feeling faint
• nausea
• sweating
• vomiting
• weakness

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred or double vision or other changes in vision
• difficulty sleeping
• dizziness when rising from a lying down or sitting position
• dry mouth
• fast, slow, or pounding heartbeat
• loss of appetite
• symptoms of withdrawal (e.g., nausea, vomiting, diarrhea, anxiety, shivering, cold and clammy skin, body aches, loss of appetite, sweating)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• signs of a bowel blockage (abdominal pain, nausea, severe constipation)signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of breathing problems (e.g., shallow, irregular breathing, or slow or troubled breathing)
• signs of severe skin reactions (e. g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
• symptoms of overdose (e.g., cold, clammy skin, abnormally slow or weak breathing, severe dizziness, confusion, slow heartbeat, or extreme drowsiness)
• symptoms of serotonin syndrome (e.g., confusion, fast heartbeat, hallucinations, restlessness, shaking, shivering, sudden jerking of muscles, sweating)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

February 19, 2021

Health Canada has issued new restrictions concerning the use of acetaminophen. To read the full Health Canada Advisory, visit Health Canada’s web site at https://recalls-rappels.canada.ca/en/alert-recall/unintentional-exposure-young-children-adult-acetaminophen-tablets-may-pose-serious

Abdominal conditions: Oxycodone may make the diagnosis of abdominal conditions more difficult or it may worsen these conditions. People with abdominal conditions such as inflammatory or obstructive bowel disease, acute cholecystitis, or pancreatitis should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Accidental use: When oxycodone – acetaminophen is used by anyone other than the person for whom it was prescribed, the effects of the medication may be fatal. Children are especially at risk. Keep this medication out of sight and reach of children.

Alcohol and other medications that cause drowsiness: People taking this medication should not combine it with alcohol, and should avoid combining it with other medications that cause drowsiness or slow down your breathing (e.g., antidepressants, sleeping pills, anxiety medications). Doing so can cause additive drowsiness and reduced breathing, as well as other side effects, which can be dangerous and possibly fatal.

Breathing: Oxycodone can suppress breathing. People at risk for breathing difficulties, such as asthma, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Dependence and withdrawal: This medication contains oxycodone. Physical dependence, psychological dependence, and abuse have occurred with the use of oxycodone. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while taking this medication. Abuse is not a problem with people who require this medication for pain relief. If this medication is stopped suddenly, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shaking, pain, nausea, tremors, diarrhea, and hallucinations. If you have been taking this medication for a while, it should be stopped gradually as directed by your doctor.

Drowsiness/reduced alertness: This medication may cause drowsiness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.

Head injury: People with head injuries or increased pressure in the head may have a higher risk of experiencing side effects (breathing problems) or worsening of their condition while taking this medication. These people should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Decreased kidney function can cause this medication to build up in the body, causing side effects. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Acetaminophen can cause severe and potentially fatal liver damage. Acetaminophen is a common ingredient in many non-prescription medications for colds and flu, pain, arthritis, and fever. Check the product label on all the medications you are taking to make sure that you are not exceeding the recommended dose of acetaminophen. An overdose of acetaminophen can lead to potentially fatal liver damage.

Contact your doctor immediately if you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin.

Low blood pressure: This medication can make low blood pressure worse or cause low blood pressure, which may be severe. If you experience severe dizziness, especially when standing from a lying or sitting position, contact your doctor.

Other medical conditions: People about to undergo surgery of the biliary tract should use caution while taking oxycodone as it may worsen their condition. Oxycodone will worsen the effects of acute alcohol intoxication and delirium tremens.

As well, people with an irregular heart rhythm, low blood pressure, low thyroid (hypothyroidism), Addison’s disease, benign prostatic hypertrophy (enlarged prostate), urethral stricture, decreased function of the adrenal glands, or porphyria should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Seizures: This medication may cause seizures, especially when higher doses are used or when taken with other medications that may increase the risk of seizures. The risk of seizures is also higher for people with epilepsy, a history of seizures, or who are at risk of seizures (e.g., people with head trauma).

Serotonin Syndrome: Although rare, severe reactions are possible when oxycodone is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors, medications used to treat depression. These combinations should be avoided if possible. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible. 

If you are taking antidepressants, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Infants born to mothers who have taken oxycodone during pregnancy have been born with signs of narcotic withdrawal. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking oxycodone and acetaminophen, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using full-strength oxycodone – acetaminophen have not been established for children under 18 years of age.

Seniors: Seniors who take this medication may be more likely to experience side effects or worsening of preexisting medical conditions.

What other drugs could interact with this medication?

There may be an interaction between oxycodone – acetaminophen and any of the following:

• acetazolamide
• aclidinium
• alcohol
• amphetamines (e. g., dextroamphetamine, lisdexamfetamine)
• anesthetics
• antihistamines (e.g., bilastine, cetirizine, dimenhydrinate, diphenhydramine, hydroxyzine, rupatadine)
• antipsychotics (e.g., haloperidol, quetiapine, olanzapine, perphenazine, risperidone, thioridazine)
• aprepitant
• atropine
• azelastine
• “azole” antifungal medications (e.g., fluconazole, itraconazole, ketoconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• benztropine
• bosentan
• brimonidine
• buprenorphine
• bupropion
• buspirone
• butorphanol
• cannabis
• chloral hydrate
• clidinium
• cobicistat
• conivaptan
• diuretics (e.g., amiloride, bumetanide, furosemide, hydrochlorothiazide)
• desmopressin
• diltiazem
• diphenoxylate
• disopyramide
• domperidone
• dronedarone
• efavirenz
• etravirine
• eluxadoline
• entacapone
• enzalutamide
• eplerenone
• esketamine
• fesoterodine
• flibanserin
• flunarizine
• glycopyrrolate
• grapefruit juice
• HIV protease inhibitors (e. g., darunavir, indinavir, lopinavir, ritonavir saquinavir)
• ipratropium
• isoniazid
• kava kava
• lemborexant
• letermovir
• lidocaine
• linezolid
• lithium
• macrolide antibiotics (e.g., clarithromycin, erythromycin,)
• methylene blue
• metoclopramide
• mifepristone
• mirabegron
• mirtazapine
• modafinil
• monoamine oxidase inhibitors (MAOIs; e.g., tranylcypromine, phenelzine, moclobemide, rasagiline, selegiline)
• muscle relaxants (e.g., baclofen, methocarbamol, orphenadrine)
• naltrexone
• other narcotic analgesics (e.g., fentanyl, codeine, morphine)
• oxybutynin
• pegvisomant
• phenylephrine
• pomalidomide
• pregabalin
• protein kinase inhibitors (e.g., ceritinib, crizotinib, dabrafenib, dasatinib, imatinib, nilotinib)
• quinidine
• rifabutin
• rifampin
• ropinirole
• rotigotine
• St. John’s wort
• scopolamine
• seizure medications (e.g., carbamazepine, felbamate, lamotrigine, levetiracetam, phenytoin, primidone, topiramate, vigabatrin)
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline)
• serotonin/norepinephrine reuptake inhibitors (e.g., desvenlafaxine, duloxetine, venlafaxine)
• sodium oxybate
• somatostatin analogues (e.g., lanreotide, octreotide, pasireotide)
• tetrabenazine
• tiotropium
• tizanidine
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, desipramine, imipramine)
• tryptophan
• valerian
• verapamil
• warfarin
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.